Analysis of longitudinal marginal deterioration of ceramic inlays.

This study quantitatively and morphologically analyzed and clarified the longitudinal marginal changes of ceramic inlays and determined the mechanism for those changes. Epoxy replicas of 15 Class II ceramic inlays in permanent premolars prepared at baseline, 6, 12, 24, 48, 72 and 96 months after placement were selected. A CCD optical laser scanner was employed to measure quantitative changes in the occlusal surfaces of restored teeth. Longitudinal cross-sections of marginal areas of a ceramic inlay were computed, and two profiles of the same location obtained at different periods were superimposed using software. The area enclosed by the two profiles obtained at different periods was defined as the quantitative marginal change, and both the area and maximum depth in the area enclosed were calculated with picture analysis software. The marginal deterioration pattern was analyzed by drawing a longitudinal curve of quantitative change for each restoration. Morphological observation was carried out by scanning electron microscopy at magnifications from 20x to 75x. Quantitative measurement and morphological observation identified a sequential three-stage pattern of marginal deterioration; initial rapid progress of wear of resin composite cement in the first stage, followed by a second stage without any remarkable visible change, then rapid progression of microfractures of ceramics and/or enamel in the third stage. Boundaries between the first and second stage were found in the six and 21-month period, and those between the second and third stage at 72 months. It was concluded that longitudinal marginal deterioration of fired ceramic inlays progressed in a sequential three-stage pattern.